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HomeMy WebLinkAbout1084 MAIN ST./RTE 6A(W.BARN.) - Health 1084 Main Street West Barnstable A = 178 - 011 / I TOWN OF BARNSTABLE LOCATION R i to A SEWAGE # 0-06 6 —I �� VILLAGE 1-J24 r f3eytAS &b I4- •ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. &,pe aade �n.� 5fay 40 01$' SEPTIC TANK CAPACITY /SOO H;0 /e00 J-�WK02 LEACHING FACIL=: (type) s,,,o7A l f ya AVK (size) ALES ,t{ if NO. OF BEDROOMS BUILDER OR OWNER c l PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ?.AcJk. lk 3 Feet Well and Leaching Facili an wells exist Private Water Supply e l g ty (If y on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by +8' 1 '5 cr � a sv� 8 �t 3 (Do - q I� `f LAC-v � � ss•c� Q �L S7•0 T3 ��•s g 43 y�S y3• g 'VIO b3•� 1 � h 77• a ® 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable w16- Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information #on the computer, Daniel Hawkins use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name key. 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code rsan (508)477-0653 S114324 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. FEW Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Dan Hawkins Digitally signed by Dan Hawkins Date:2021.02.10 14:38:02-0e0a 2-5-2021 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Pl ease note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 1151nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ff, 4 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1,2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑■ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The system was in working order at the time of inspection. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r Commonwealth of Massachusetts �y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts -------- - == ................. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 1� 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (Cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the•presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: I, 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections:. Yes No Q ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form !� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t � 1084 Main Street Property Address Lauren Taylor Owner OwnEr's Name information is Barrstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow Required pumping more than 4 times in the last year NOT due to clogged or El El obstructed pipe(s). Number of times pumped: ❑ E Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ El Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ a The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ 0 The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 i Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (font.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate yes "or no"for each of the following for all inspections: Yes No ❑ El Pumping information was provided by the owner, occupant, or Board of Health ❑ E] Were any of the system components pumped out in the previous two weeks? , ❑ ❑ Has the system received normal flows in the previous two week period? ❑ El Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? Fxj ❑ Were all system components, excluding the SAS, located on site? ❑ ❑ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge and depth of scum? ❑ FX 1 Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: El ❑ Existing information. For example,a plan at the Board of Health. ❑ a Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts — Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 3 Number of bedrooms(design): Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 348/GPD Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes No Does residence have a water treatment unit? ❑ Yes Q No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonaluse? ❑ Yes [g No See below Water meter readings, if available(last 2 years usage(gpd)): Detail: ***WELL WATER*** Sump pump? ❑ Yes ❑■ No 12/23/2020 Last date of occupancy: Date t5lnsp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form t- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments --/" 1084 Main Street Property Address Lauren Taylor Owner Owners Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- date of last pump is unknown Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts �e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ❑ Septic tank, distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. El Other(describe): Tank, pump chamber, d-box and SAS Approximate age of all components, date installed (if known)and source of information: 2006 per plans Were sewage odors detected when arriving at the site? ❑ Yes ❑■ No 5. Building Sewer(locate on site plan): 3' Depth below grade: feet Material of construction: ❑ cast iron 0 40 PVC ❑other(explain): >150'from well to SAS Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage, etc.): t51nsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts tts ------------ � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 2' Depth below grade: feet Material of construction: ❑� concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1 Dimensions: 500gallons 6If Sludge depth: 3011 Distance from top of sludge to bottom of outlet tee or baffle 3„ Scum thickness 6" Distance from top of scum to top of outlet tee or baffle 1411 Distance from bottom of scum to bottom of outlet tee or baffle measured How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was in working order at the time of inspection. The tank is not in need of pumping at this time but should be pumped every two years for maintenance. 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1084 Main Street Prope-ty Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): NA Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts. -- _..__. Title 5 Official Inspection Form -T i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every St page. City/Town ate Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) . Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches,etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): 0" Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The d-box was in working order at the time of inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑. Yes ❑ No` Alarms in working order: ❑ Yes ❑ No" Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Pump chamber, pump and alarm were in working order when viewed. If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: (5)infiltrators a row E leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t51nsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts - .... Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System .Information (cont.) 11. Soil Absorption System (SAS)(cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was in working order at the time of inspection. Leaching had no standing water when viewed but bottom was damp. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): NA Materials of construction: Dimensions I Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t51nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form I1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: 0 hand-sketch in the area below ❑ drawing attached separately t r 119 +e;h;, SOIL t a r r '0-my idol-7— e 60 fA E "+ex r I At 17 rt ' '5 Y+ 1:0s +? AAA vA 155-F z c. t �; a air IN�"'` '+��' t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 h a 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments g p Y ry 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑■ Check Slope ❑■ Surface water ❑■ Check cellar ❑■ Shallow wells Estimated depth to high ground water: No GW @ 120"feet Please indicate all methods used to determine the high ground water elevation: X from❑ Obtained t o system design plans on record 9-13-2005 If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: A plan on file at the local Board of Health was used to determine high groundwater. Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 I c Commonwealth of Massachusetts - Title 5 Official Inspection Form r - a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments — 1084 Main Street Property Address Lauren Taylor Owner Owner's Name information is Barnstable Ma 02668 2-5-2021 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ❑■ A. Inspector Information: Complete all fields in this section. �■ B. Certification: Signed&Dated and 1,2, 3,or 4 checked ❑■ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate x- 4(Failure Criteria)and 6(Checklist)completed i ❑■ D. System Information: For 8:Tight/Holding Tank-Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Pag CERTIFICATE OF ANALYSIS ey.1 of 1 s.,. ^ Barnstable County Health Laboratory (M-MA009) �ss,cHus^� Report Prepared For: Report Dated: 9/14/2015 Shaun F. Harrington All Cape Well Drilling Order No.: G1590299 P0 Box 126 Brewster, MA 02631 Laboratory ID#: 1590299-01 Description: Water-Drinking Water Sample#: Sample Location: 1084 6A,W Barnstable Collected: 09/11/2015 Collected by: All Cape Well Received: 09/11/2015 Routine ITEM �,RESULT UNITS RL` MCL METHOD# ANALYST TESTED NOTE ` Nitrate as Nitrogen 1.0 mg/L 0.10 10 EPA 300.0 LAP 9/11/2015 Copper ND mg/L 0.003 1.3 EPA 200.7 LAP 9/14/2015 Iron 0.02 mg/L 0.01 0.3 EPA 200.7 LAP 9/14/2015 pH 5.8 PH AT 25C NA 6.5-8.5 SM 4500-H-6 DCB 9/11/2015 Sodium 8.4 mg/L 1.0 20 EPA 200.7 LAP 9/14/2015 Total Coliform 0 /100ML 0 0 SM 9222 B RG 9/11/2015 Conductance 100 umohs/cm 2.0 EPA 120.1 DCB 9/11/2015 Water sample meets the recommended limits for drinking water of all the above tested parameters. Attached please find the laboratory certified parameter list. Approved By...,A—/ (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 ' Sep. 14, 2C15 10:31AM k 2664 P. 1 I � CERTIFICATE OF ANALYSIS g �� r�� Page. 1 of 1 rs �� Barnstable County Health Laboratory (M-MA009) r �°racrsys Report Prepared For: Report Dated: 9111r2015 Shaun F.Harrington All Cape Well Drilling Order No.: G1590288 P O Box 126 Brewster, MA 02631 Laboratory 117 M 1690288-01 Daserlptlon: Water-Drinking Water J Sample#: Sample Location: 1084 6A West Barnstable Collected: 09/10/2015 Collected by: All Cape Well Received. 0911 DI2015 Test Parameters ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED HATE Nitrate as Nitrogen 11 mgiL 0.10 10 t;PA 360,0 LAP 9/10/2015 _ Nitrate level is above the recommended maximum contamination Level fordrinking water.Retesting Is recommended. t I bor Lo certified parameter list. Approved Attached p ease find the a a ry (Lab Director) J n. `�y'rYff ND=None Detecled RL Reporting Limit MCL W Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 608-375.6605 TOWN OF BARNSTABLE LOCATION , SEWAGE # VT,LAGE: , ASSESSOR'S MAP & LOT�� " INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS .yam, B OR OWNER PERMTTDATE: COMPLIANCE-DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist , on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by No# W6 —/25— __._. Fee A® T.._ THE %COMANIONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Migonl *pgtem Conztruction Permit Application for a Permit to Construct( ) Repair( ) Upgrade C,,� Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0 QQ .• nMA 3 ST-. Owner's Name, e,Address,\and Tel.No. Assessor's Map/Parcel 7$ �l6X"TX6� " + '" " ` Installer's Name, dres nd Tel. 0.1 l � Designer's Name,Address and Tel.No. V6L.0 S( l �� 1 i sty OfZZ � (oA,ywpp• -�M . DZIo�S ►n•b•80Y 7(3 1WiLLC NA . 02*32- --V 2- NS2. Type of Building: Dwelling No.of Bedrooms Lot Size s . Garbage Grinder (O Other Type of Buildin No.of Persons Showers(1/f Cafeteria(s/� Other Fixtures ►.� 1J Design Flow(min.required) gpd Design flow provided gpd Plan Date ' Number of sheets RelviSion Date Title —1�� tfisllj Size of Septic Tank 00 Type of S.A.S. Description of Soil 5eET PLAT-j 1lyl L L-r t���- C 6-1-S Nature of Repairs or Alterations(Answer when applicable) . t Pvalp C (i+�-'�Br'x-{ S P►3�t�T, f.ktrwl 6C-�CS Date last inspected: e "L--j)10M Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar lth. t� ned Date -1 "t / © s® Application Approved Date IWO Application Disapproved by: Date for the following reasons Permit No. ')k '' �� Date Issued ,rzNc '- lU /� Fee ®D i Entered in computer:' om uteri THL4=C IIONWEALTH OF MASSACHUSETTS / p Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE; MASSACHUSETTS ZippYica:tiou for �Digpogal *pgtem 6n5truction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(✓j Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Q M A I NJ S r- Owner's Name,Address,and Tel.No. nvJ'r A(tn`�srJ�B LE �p (� l�tL Assessor's Map/Parcel 7 D 11 1 + : a 15D8)lk8-�{) 1 Installgr's Name, dres d Tel. o. Designer's Name,Address and Tel.No. G 1 SETS 4 G 7-3 � (Pa.,yA�.N o0 MA aZ�`75 G� 6.80Y 7 b3 , c.1✓ I LLB MA . U2b32 � , 2— 3 2— Type of Building: Dwelling No.of Bedrooms Lot Size I too 01) — s . fix Garbage Grinder (t* 4 ,Other Type of Build' Er,I E A No.of Persons Showers(VS Cafeteria(� t Y�.A • s OV-- �JD - Other Fixtures Design Flow(min,required) 330 gpd Design flow provided gpd Plan Date 3� �Op'�"� Number of sheets Revision Date Title tttJf 5 L S --1ti1 N Size of Septic Tank fi_` t�` Type of S.A.S. Description of Soil 5GE PLA 1,I) A-—Ib4- C 1'+A-�-A 15&VI S Nature of Repairs or Alterations(Answer when applicable) Q. 't��7l� P�-- �.J PUMP d (•144 Bti- S tul=ILT. D LL.otJ lk c fl�wt sc-cS xim --� . tc�LLAII_NF t- Date last inspected: CL6 Div Agreement: \ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board 5-f:k . k,> Signed � �� Date ! Application Approved by. Date ' ® rP Application Disapproved by: Date for the following reasons -25 Permit No. �' Date Issued t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of ion riance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ✓) Abandoned )by CM&3&3 , '�`` LO ���D'lu.� � t J1 at I OB4 IAA•((j S T • W- I hdDLc has been constructed in accordance ''// `` with the provisions of Title 5 and the for Disposal System Construction Permit No. ca)� `� dated yd '! Installer 'C,"EwioE_ G -Ppi%tS Designer RIU4 hAAS — LaLr 5LAQL-M IkV, I` #bedrooms Approved design flow 3� gpd The issuance of this permit shall n/t be co /strued as a guarantee that the system will fuunc o design d. Date rl1 SJ r �t� Inspector No. Fee 160 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS �Oigool Q�pgtem Construction Permit Permission is hereby granted to Const icy (;, ) Re air (�,) Up grad ( ) Abarkdo, ( ) System located at ���� D ►�(� n 1'Qr' 12 i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or speciaalfcon�ifions.. Provided: Constructionmust b6 completed within three years of(he date of t,-is Date Appr®ved_b_y `q�F j I i Town of Barnstable Regulatory Services a � Thomas F. Ceiler,Director A+ ' Public Health Division ++ Thomas McKean,Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Desiener Certification Form Date: Sewage Permit# ' � d�7 Assessor's MapTareel /716 tl Designer: 5�N� Installer: A G[ E �'u.c di,uc; , /,-,< Address: '9JL r 4 �4 Address: 0 3 o,t -7 T4 3 �o-Tr l�a�� , �.-t A, o z G 1 j LL i was issued a permit to install a (date) (installer septic system at log .a�A.; ST, w J `C, based on a design drawn by i (address) dated /r z z o(� ,Z G-vi c3i 'J!10/d 1— (designer) Aef I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical:relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. rpm staller's i nature) Na3046t AL (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTI1 DIVISION. THANK YOU. QASCOMDcsigner Certification Form Reviscd.doe l Ij Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM H`A'1^5 ,hereby certify that the engineered plan signed by me dated it .. 2z b�' ,concerning the property located at &S`f ��•� zT w ��.�,�s!►ems z€ meets all of the following criteria: • Two soil evaluations excavated for detailed examination(no hand augering)and two percolation tests shall be conducted. • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than.or equal to 5 minutes per inch. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) --39 B) G.W. Elevation +adjustment for high G.W. _ R. DIFFERENCE BETWEEN A and B 221 r SIGNED : DATE: NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. gASepti4ercexemp.doc l Town of Barnstable. Health Inspector �WE Office Hours Regulatory Services 8:30—9:30 Thomas F.Geiler,Director 1:00—2:00 snexsTnar.s, Public Health Division ArFop Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT-SEPTIC QUESTIONNAIRE 1. General 'Information: Size of Property: 215D Address: IoKq U& V Map 179 Parcel 0/L Name: QA f 6( Phone#: (326Z7 —VD`IZ 2a. How many bedrooms exist at your property now? J 2b. Are you planning to add any bedrooms?/ I I� If yes,how many? 2cHow many bedrooms total are proposed at this property(including the amnesty unit)? 2d. Please include a copy of the floor plans for the entire property-showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or ONO If the dwelling is.connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE or UTSIDE a Zone of Contribution to public supply wells?" 5. Is the dwelling connected to an NSITE WELL or to PUBLIC WATER? 6. Is a disposal works construction permit on file? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. < nditio Q;/health/wpf:les/amnestyapp Signed: Date: FOR MAIL-IN APPLICATIONS Please mail a completed application:form to the address below. Please include a copy of the floor plans for the entire property- showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED APPLICATIONS Our fax number is (508) 790-6304. Please fax a completed application form. Please include a copy of the floor plans for the entire property- showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. For further assistance on any item above, call (508) 862-4644 To get an amnesty program septic questionnaire form, click here. To be able to access this form, your computer must have Acrobat Reader. Most computers have Acrobat Reader, and it will usually activate itself automatically. If your computer does not have Acrobat Reader, you can download a copy of it by going to the Adobe website. Back to Main Public Health Division Page Q;lhealth/wpfiles/amnestyapp pp— TOWN OF BARNSTABLE LOCATION , SEWAGE # VILLAGE ' lr/1� ,J ASSESSOR'S MAP & LOT/ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Z (size) NO.OF BEDROOMS B OR OWNER ���'3/ / /� j- I PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by e a WE » The Town of Barnstable 1 � Growth Management Department 367 Main Street, 3 d Floor Hyannis, MA 02601 Tel:508-862-4678 Fax:508-862-4782 April 23,2008 John C. Klimm,Town Manager Janet Joakim,Town Council President Barnstable Town Hall 367 Main Street Hyannis,MA 02601 Re: Scott and Lauren Taylor, 1084 Main Street, West Barnstable;two-bedroom accessory unit This letter is to inform you that the Accessory Affordable Apartment (Amnest� Program has received a request for a project eligibility letter under the Community Development Block Grant (CDBG) Fund and under Article II of Chapter Nine of the Code of the Town of Barnstable and the criteria for the Local Chapter 40B Program. This office is reviewing the request. If the Town has any comments on the project, please forward them to me so that they can be addressed in the site approval letter. This letter gives you official notice of our receipt of the above application(s). We will issue a decision as to the acceptability of the sites and the consistency of this development within the guidelines of CDBG. Sincerely, Elizabeth Dillen Special Projects Coordinator Growth Management Department ; _ cc: Building Division Health Division b/ CO +M • 6 r , 1 ' a , 1 1.7 f i 1 , 7 I I ' 1 «,�- � J--y'+..--.._ice-fir...,..+_-+i _' - .. fi�_� ,.._.._..._-/...- � __-. ..__-'"__•_•__.-."__ _ -P t� _.1��..-_ate-.._�.-.I ...�y-...._`•,...,_,_{ �/�V•.,.,...��'V,"'��•.N.._ —I_tea __---_-__ -_,_�.._.._ ..--• - — — - - - ... r � , `a i r - --"' s _ Z i I __.._- .-,-.-''-.-- ... T _r'--._1-..-.-.i'•--"'.,-�,..�.+w- �•+-..,_�.- -.I�L...._. _..�...:._.-..�4 1--,��- '__ ' _- `i'-_ ------------ T�l --tio7l,A�E7�TW, d 1 — t . LLL • i' ! f 1 rye.� j _. .. _ _ ,. •. -_._ + gyp, r _.._.. _ j} i{S _ __ ,fi fi t 1 t //.. �[ # , +� ' _t�..t_.I .F-- _"___f_---�"—� ,.....�.•e—_ �� � F III � _ �..... a-.n.'.�• 1 (`".`.'d^'t .. , r , , 1 j ! y t v • � { i � t� � �� €c._ ` I " 3 i"`t, i .� _t �~ � ;� ���� 1. �. ����`��J'-�v� Z" x l'1--f� -. _. t }... ` a { ,_.�,.Y,,..,,,,-,.-fi_...... y y t,...__ y � � .fi.A _} 5 � ._.�.—.� ,,.._ _!_...: 1 ; , ,d� � t' ` ._•_. s r t I ' T i S-_ x 111 , 1 f — 7-7 ' s I pp ' T {.� �' ... -_..--.-• �..,,r_!.�.��S'-' __ ` __ __—f.--t 1 __ _ t� .,._:..__i._ i_ ,-..�.._..17. _...-�....- _ �_--:-F•_._......>.-..».-,/_,_...-��lG-df ` �j_ L 'Fj� 1 f t r i r — , r a✓ t 1 _ y —.— - 1 , AZI Al ol 1 , + i U— ; � ( j i � 1 f i�i 1 t 3 t j I I 1 ' + s , : — c. . _ � x 1 I , - t + >e , t s , 1 � 1 4 . f r 1 ' + 1 4 , �J �3 z ( .S�rt71 lr � � _ /J� OV as . Wo 1 d c G � l S Z i '7 �' w � � L Le- le re el v t t ^ 3 h? I• ti it i OBSERVATION ELEVATIONS : 9 MINIMUM COVER INVERT_ C L VAT 0 . ' FIRST 2' TO PORT TO .GRADE NS DESIGN CR l TER I A . MIN. 2' OF INVERT AT BUILDING 100.0 ACCESS COVERS MUST BE W/TH1N BE LEVEL : DESIGN FLOW. TEE PEAS TONE 4'VENr INVERT IN SEPTIC TANK: 99. / Jr'BEDROOMS AT /l0 G.P.D. PER 6. OF FINISH GRADE j INVERT OUT SEPTIC TANK: 98.85 BEDROOM EOUALS 330 G.P.D. 01.4 2X -�.., IB' MIN ��GrF a� 100.7 INVERT IN PUMP CHAMBER: 96.75 V 40 MILL POLY INVERT OUT PUMP CHAMBER: 98.75 NO GARBAGE GRINDER l00''; 7' VAPOR BARRIER t- DIAU IPE o INVERT IN DIST. BOX: 100.37 QQ 2' SCH 40 PVC 10.2 I SEPTIC TANK REOUIRED: o / 5 STANDARD INFILTRATOR 96.7 INVERT OUT D/ST. BOX: 100.2 85 330 G.P.D. X 200V - 660 GAL. G i CHAMBERS W/4' STONE AROUND 3/4' - l l/2' DIA. INVERT /N LEACH CHAMBER: 100. 14 �, SEPTIC TANK PROVIDED: 1500 GAL. MIN. Aq��Rogo eAFFtE 30 BOX OUTLET I1.'► X 36'1 X 7'd DOUBLE WASHED STONE BOTTOM LEACH CHAMBER: 99.56 o OBSERVED HIGH GROUNDWATER: 94.56 SOIL ABSORPTION SYSTEM REQUIRED: 1500 GAL H-10 /000 GAL H-10 JOBSERVED HIGH BOTTOM OF TEST HOLE +►J: 89.2 SEPTIC TANK GROUNDWATER. EL- 94.56 DESIGN PERC RA TE ( 5 MI N/I NCH \� PUMP CHAMBER - SOIL TEXTURAL CLASS - l EFFLUENT LOADING RATE - 0.74 GPD/SF 330 GPD / 0.74.GPD/SF - 446 S.F. REQUIRED 6' CRUSHED STONE OR ' LOCUS MAP J COMPACTED BASE PROVIDED: 5 STANDARD INFILTRATOR 1 CHAMBERS W/4' STONE AROUND. A-475 S.F. PROFILE : NOT TO SCALE 40 MILL POLY 475 S.F. x 0.74 - 351 GPD GENERAL NOTES : VAPOR BARRIER \ SOIL REMOVAL l. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION { h SEE NOTE 10. SOIL TEST P l T DA TA OF THE SEWAGE DISPOSAL SYSTEM ONLY. INDICATES v\' PERCOLATION OBSERVED 2. � VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS - P+ ��' � � s STANDARD TEST - GROUNDWATER SET.' SEE SITE PLAN.` INFILTRATOR CHAMBERS W/4• STONE AROUND TP *I TP •2 3. ALL CONSTRUCTION METHODS AND MATERIALS AND - -- .' \ 9 .s HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR MA/NTENANCE OF THE SEPTIC SYSTEM SHALL oe.a i \ ' LOAMY IOYR A LOAMY IOYR CONFORM TO MASS.' D.E.P. TITLE 5 AND LOCAL D-Box \ ;'� A SAND 4/2 SAND 4/2 BOARD OF HEALTH REGULATIONS. _ y' _ •• 98.4 10' •• 98.6 o. TP+2 9p p LOAMY IOYR p LOAMY IOYR 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER �5 \ 'z L7 D " cEsspoocs ., � c SAND 5/6 SAND 5/6 AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER sHED \ 30 �= 96. 7 28' 97. 1 THAN 3' IN DEPTH SHALL" BE CAPABLE OF WI TH ( \ C MEDIUM IOYR C / MEDIUM IOYR �� roo.9 STANDING H-20 WHEEL LOADS. F. �,, \\\ SAND 6/8 SAND 6/8 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR r' / ,� OBSERVED APPROVED EQUAL. WELL 1 �100.2 511612006 = 94.56 CyAP R 46. 42. 6. SEPTIC TANK. PUMP CHAMBER AND D-BOX SHALL BE �9�y y BM-CORNER OF STEP REINFORCED PRECAST CONCRETE. WATERTIGHT AND EL - 103.21 2 6 Isoo GAuoN SEPTIC TANK f......._.. ..: --- ...:- 9I.2_, -t-08.= :"..... - ... ... 90.fi WATERPROOF. D-BOX SHALL BE WATER TESTED TO 1Fo y I2'APPLE CHECK FOR LEVEL WHEN THERE IS MORE THAN ONE �ooy G DEN _ _______ C2 CLAY I OYR C2 CLAY IOYR OUTLET. �' 5/2 5/2 I20' 89.2 120' 89.4 "` NO WA TER NO WA TER 7. BEFORE CONSTRUCTION CALL 'DIG-SAFE'. \ \e- �\ /� DATE: SEPTEMBER 13. 2005 1-886-DIG-SAFE AND THE LOCAL WATER DEPT. SECOND FLOOR PLAN e �� ------- \\ ,'� TEST BY: STEPHEN HAAS FOR LOCATION OF UNDERGROUND UTILITIES. �o'Qooy � \\ �.' PERC RATE: C 2 MIN/INCH 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION OF THE,SYSTEM TO ALLOW FOR SCHEDULING OF THE CONSTRUCTION INSPECTIONS. 900 i s i 1 i t f +2 otL e 9. EXISTING CESSPOOLS TO BE PUMPED DRY AND �o � � •: `L`..`� ;•-.`.. -.� BACKFILLED. ; y� 10. ALL UNSUITABLE MATERIAL fA B HORIZONS) 909y, ' ENCOUNTERED BELOW THE INVERT OF THE LEACHING FACT L I TY TO BE REMOVED FOR A D/STANCE OF 5' AROUND AND REPLACED W/TH SAND .IN ACCORDANCE SEP T / C' S YS TE-M LEES / G/\/ WITH TITLE 5. WELL - QPa \\ , / 0 8-4 MA / !V S TR EE` T . MA f' 178 . P,4 R CEL / wES T &AR/\/S TASL H "A i -s R E'PAREU FOR . \ Or. HELL S C0 T T TA YL OR PUMP SYSTEM NOTESol S.CA L E- : / 2 0 'y � � /VOVEMBER 22 , 20D.S - � \ \ PVC INLET CouPt NO PVC " 1. PUMP TO BE MYERS RESIDENTIAL SEWAGE PUMP MODEL SRM4 - � v ` : � OUTLET • OR Eoval. .� Y L REV/SED MA Y 16. 2006 WEEP ` . MERCURY FLOAT HOLE \ SWITCHES CHECK ?. THE PUMP SHALL -START AND STOP AT THE ELEVATIONS SHOWN. � / y ALARM ON YALYE EAGLE - UF� �/-EY I NO I NC J. THE PUVP SHALL BE INSTALLED !N STRICT CONFORMANCE WITH ' _ ! _ - � THE MANUFACTURERS SPECIFICATIONS AND TITLE V REGULATIONS.. PUP •,••„' 4, 9 PUMP DISCHARGE SHALL BE? INCHES. PUMP SHOULD BE ABLE TO i \ I PUMP OFF ► .. 2 3 R O U t @ 6 A BE DISCONNECTED'AND LIFTED OUT OF THE PUMP CHAMBER WITHOUT "' \� d' t _, .� Ya rmou t hpO r t MA . 02675 HAVING TO ENTER THE PUMP CHAMBER. C J 0 8 3 6 2-8 1 3 2 _ • .. 508 432 5333 4. : ';THE ALARM SHALL START AT THE ELEVATION.SHOWN AND BE POWERED BY A CIRCUIT SEPARATE FROM THE PUMP POWER. PUMP DE TA!L . NOT To SCALE USING 000 P AM 1 GAL. PUMP CH BER -. - RiPm w R A OR THIS : N TA AT ON. ATE T 1 GHT AND W TERPROOF 5.-, AN ELECTRICAL PERMIT MUST BE OBTAINED F TH ! S LL / i 0 IO 40 _ 20 _ JOB NO. 05 07 F l I EL D CFW/EEK CAL C SAH7CFW CHECK CFW DRN. SAH i j